ABSTRACT
Abstract Introduction Ongoing research in the use of electromagnetic stimulation as coadjuvant in fracture healing has led the authors to begin generating computer models in order to predict cellular growth changes when cells are electromagnetically stimulated. By generating these models, scientists will be able to better understand how electromagnetic fields affect cellular development. The experimental design integrated a cellular culture bioreactor along with an external magnetic stimulation system, which allowed for dermal models to be exposed to controlled magnetic fields. Methods Initially, it was necessary to analyze the static growth of Normal Human Skin Fibroblast (NHSF) cells when they were exposed to Extremely Low Frequency – Electromagnetic Fields (ELF-EMFs). Using optimal conditions for the NHSF culture, from stimulation signal to scaffolding material, we were able to perform the dynamic flow stimulation experiments. Results The following systems were developed: (1) a bioreactor aimed at cellular tissue culture, and (2) Helmholtz coils capable of generating stimulation signals for the cultured tissue. The authors were able to appreciate the quantified values of cellular density diluted in all the experiment samples that were taken and overall, the irradiated samples displayed an average increase of 53% higher cellular density for the same amount of initial cellular seeding when the cells were exposed to a 1 mT, 60 Hz magnetic field signal. Conclusion ELF-EMF’s indeed alter NHSF cell growth rates and it is the challenge of the authors to continue investigating what cellular mechanisms are altered when cells are exposed to ELF-EMF’s.
ABSTRACT
Introduction: There is controversy in medical literature regarding the use of electromagnetic fields to promote bone healing. Methods: After designing and building devices capable of generating an electromagnetic field for this study, their safety was confirmed and the electromagnetic therapy was randomly allocated and compared to placebo in patients with fracture of the femoral diaphysis. Treatment began six weeks after the fracture and it was administered once a day, during 1 h, for eight consecutive weeks. Twenty devices were built, 10 of which were placebo-devices. Between June 2008 and October 2009, 64 patients were randomized in two different hospitals and were followed for 24 weeks. The mean age was 30 years (18-59) and 81% were males. Results: Healing observed at week 12 was 75% vs. 58% (p= 0.1); at week 18, it was 94% vs. 80% (p= 0.15); and at week 24, it was 94% vs. 87% (p= 0.43) for the device group and the placebo group, respectively. Discussion: This study suggests that an electromagnetic field stimulus can promote earlier bone healing compared to placebo in femoral diaphyseal fractures. Faster bone healing translates into sooner weight bearing, which - in turn - permits quicker return to normal daily activities.
Introducción: El uso de estimulación electromagnética como coadyuvante en la consolidación de fracturas es controversial en la literatura médica. Métodos: Para este estudio, se diseñó y construyó un dispositivo capaz de generar un campo electromagnético. Tras confirmar su seguridad se asignaron pacientes aleatoriamente con fractura diafisaria de fémur a recibir terapia electromagnética o placebo. La estimulación inició a las seis semanas de la fractura, 1 h diaria, por ocho semanas consecutivas. Se construyeron 20 dispositivos, 10 reales y 10 dispositivos-placebo. Entre junio 2008 y octubre 2009, ingresaron 64 pacientes al estudio de dos instituciones y fueron seguidos durante 24 semanas. El promedio de edad de los pacientes fue de 30 años (rango 18-59) y 81% eran de sexo masculino. Resultados: La consolidación observada para el grupo con el dispositivo y el grupo placebo fue: en la semana 12, 75% vs. 58% (p =0.1); en la semana 18, 94% vs. 80% (p =0.15) y en la semana 24, 94% vs. 87% (p =0.43). Discusión: Este estudio muestra una tendencia a la consolidación más temprana al estar expuesto a un campo electromagnético frente a placebo. Una consolidación más temprana permite un apoyo precoz y, así, más rápida reincorporación al trabajo y a las actividades cotidianas.